US7651478B2 - Surgical access device with floating gel seal - Google Patents
Surgical access device with floating gel seal Download PDFInfo
- Publication number
- US7651478B2 US7651478B2 US11/753,752 US75375207A US7651478B2 US 7651478 B2 US7651478 B2 US 7651478B2 US 75375207 A US75375207 A US 75375207A US 7651478 B2 US7651478 B2 US 7651478B2
- Authority
- US
- United States
- Prior art keywords
- valve
- axis
- gel material
- seal
- trocar
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Fee Related, expires
Links
- 239000000463 material Substances 0.000 claims abstract description 59
- 238000003780 insertion Methods 0.000 claims description 4
- 230000037431 insertion Effects 0.000 claims description 4
- 238000012423 maintenance Methods 0.000 claims description 2
- 239000011800 void material Substances 0.000 claims 3
- 238000005188 flotation Methods 0.000 abstract description 7
- 239000007789 gas Substances 0.000 description 6
- 210000000683 abdominal cavity Anatomy 0.000 description 5
- 210000003815 abdominal wall Anatomy 0.000 description 3
- 238000000034 method Methods 0.000 description 3
- 238000012986 modification Methods 0.000 description 3
- 230000004048 modification Effects 0.000 description 3
- CURLTUGMZLYLDI-UHFFFAOYSA-N Carbon dioxide Chemical compound O=C=O CURLTUGMZLYLDI-UHFFFAOYSA-N 0.000 description 2
- 230000006835 compression Effects 0.000 description 2
- 238000007906 compression Methods 0.000 description 2
- 239000013536 elastomeric material Substances 0.000 description 2
- 238000002357 laparoscopic surgery Methods 0.000 description 2
- 239000007787 solid Substances 0.000 description 2
- 210000001015 abdomen Anatomy 0.000 description 1
- 229910002092 carbon dioxide Inorganic materials 0.000 description 1
- 239000001569 carbon dioxide Substances 0.000 description 1
- 238000010276 construction Methods 0.000 description 1
- 230000003993 interaction Effects 0.000 description 1
- 239000007788 liquid Substances 0.000 description 1
- 230000007246 mechanism Effects 0.000 description 1
- 238000007789 sealing Methods 0.000 description 1
- 238000001356 surgical procedure Methods 0.000 description 1
Images
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3498—Valves therefor, e.g. flapper valves, slide valves
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3462—Trocars; Puncturing needles with means for changing the diameter or the orientation of the entrance port of the cannula, e.g. for use with different-sized instruments, reduction ports, adapter seals
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3415—Trocars; Puncturing needles for introducing tubes or catheters, e.g. gastrostomy tubes, drain catheters
Definitions
- This invention relates generally to surgical access devices and more specifically to valves and seals associated with such devices
- Access devices are commonly used to facilitate the introduction of surgical instruments into body conduits and body cavities.
- One such device which is typically referred to as a trocar, is used in laparoscopic procedures to provide access through the abdominal wall and into the abdominal cavity.
- the abdominal cavity is commonly inflated or insufflated in order to increase the volume of the working environment.
- valves are provided in a valve housing of the trocar to inhibit the escape of the insufflation gas. The valves form an instrument seal in the presence of an instrument, and a zero seal in the absence of an instrument.
- Trocar seals are disclosed and claimed in applicant's U.S. Pat. No. 5,385,553, which is incorporated herein by reference. This patent discusses the problems which can be encountered when the instrument is inserted off-axis. The solution of floating the valve is discussed in detail.
- the valve would comprise first portions which define an orifice through the valve and second portions disposed outwardly of the first portions. These second portions are intended to provide a greater flexibility than the first portions As a consequence, when an instrument is inserted off-axis, the second portions will deform while the first portions, which form the instrument seal, will remain undeformed.
- One of the embodiments contemplates provision of an excess of material disposed outwardly of the valve orifice which functions generally as a bellows
- the first portions of the valve have a first radial length to radial distance ratio while the second portions of the valve have a second radial length to radial distance ratio.
- the valving mechanism is formed generally of a solid but elastomeric material.
- an access device for example, in the form of a trocar having a valve housing
- a valve assembly is disposed in the housing and includes a gel material which has superior sealing characteristics and flotation properties.
- the gel is a solid in that it has a generally fixed volume.
- the gel functions somewhat like a liquid in that it tends to “flow”
- Other characteristics of the gel material such as an elongation greater than 1000 percent, a low durometer and an excellent tear strength are disclosed and claimed in applicant's International Application No. PCT/US01/29682. This application, which was filed on Sep. 21, 2001 and entitled “Surgical Access Apparatus and Method”, is incorporated herein by reference.
- the gel material will typically form a seal with the valve housing and may also be used to form the instrument seal as well as the zero seal.
- the valve assembly can be formed with a typical septum valve supported by the gel material to provide the septum valve with the superior flotation properties.
- voids can be created in the housing or even within the gel material to accommodate compression of the material during insertion of an instrument
- a trocar has an axis and is adapted to provide access for a surgical instrument across a body wall and into a body cavity
- a cannula disposed along the axis, has a proximal end and a distal end, and is adapted for disposition across the body wall.
- a housing disposed along the access at the proximal end of the cannula is adapted to receive the surgical instrument and to introduce the instrument into the cannula.
- a valve is disposed in the housing and provided with properties for forming a first seal with the housing wall, a second seal with the instrument when it is present in the trocar and a third seal with itself when the instrument is absent from the trocar.
- a gel material included in the valve has flotation properties for maintaining the second seal even when the surgical instrument is moved laterally of the axis of the trocar.
- a valve assembly in another aspect of the invention, includes a septum valve disposed in the valve housing and adapted to form a first seal with the instrument when it is received into the trocar.
- a valve support is disposed between the septum valve and the housing to float the septum valve relative to the housing.
- the valve support includes a gel having elongation greater than 1000 percent to facilitate maintenance of the first seal during off-axis movement of the instrument relative to the housing.
- the septum valve can be insert molded to the valve support
- a valve is disposed in the valve housing and adapted to form a seal with the instrument when the instrument is inserted through the valve housing and into the cannula
- Portions of the valve include a gel material having properties for moving relative to the axis to maintain the seal with the instrument when the instrument is moved off-axis.
- Voids can be formed in proximity to the gel material to facilitate movement of the material relative to the axis, These voids can be formed primarily on the walls of the valve housing, between the walls and the gel material and even within the gel material.
- FIG. 1 is a side elevation view of a patent operatively position with a trocar extending into the abdominal cavity and providing access for a surgical instrument;
- FIG. 2A is an axial cross section view of one embodiment of the trocar, and illustrates a zero seal configuration in the absence of the instrument;
- FIG. 2B is a cross section view taken along lines IIB-IIB of FIG. 2A ;
- FIG. 3 is an axial cross section view of the trocar illustrating an instrument seal formed during off-axis insertion of the instrument;
- FIG. 4 is an axial cross section view of another embodiment of the invention including a septum seal and a floating gel support;
- FIG. 5 is an axial cross section view of another embodiment of the valve apparatus.
- FIG. 6 is an axial cross section view of a valve apparatus with gel material including air pockets.
- FIG. 7 is an axial cross section view of a further embodiment illustrating air pockets formed in the seal housing.
- FIG. 1 A patient is illustrated in FIG. 1 and designated generally by the reference numeral 10
- the patient 10 is illustrated in a prone position on an operation table 12 where he is prepared for laparoscopic surgery. This type of surgery is performed within the patients abdominal cavity 14 with minimal access through an abdominal wall 16 .
- This access is typically provided by a trocar 18 having a cannula 21 and valve housing 23 .
- the trocar 18 may be one of several trocars which are used simultaneously to provide access for surgical instruments such as the instrument 25 illustrates in the form of a laparoscope.
- the abdomen 14 is typically inflated with an insufflation gas, such as carbon dioxide, in order to distend the abdominal wall 16 and thereby increase the volume of the working environment It is the purpose of the valve housing 23 and associated valves to maintain this insufflation gas within the abdominal cavity 14 , both in the presence of the instrument 25 and in the absence of the instrument 25
- an insufflation gas such as carbon dioxide
- FIG. 2 One embodiment of the trocar 18 of the present invention is illustrated in FIG. 2 .
- the trocar 18 is shown to include the cannula 21 with a working channel 26 (extending generally along an axis 27 ), a proximal end 30 , and a distal end 32 .
- the valve housing 23 is coupled to the distal end 32 in coaxial alignment with the cannula 21 .
- valve housing 23 is constructed with a cylindrical, vertical wall 34 and a pair of generally annular horizontal walls 36 and 38
- the wall 36 can be disposed generally perpendicular to the axis 27 with portions defining an exterior opening 41 for instrument access.
- the wall 38 is generally parallel to the wall 36 and defines an interior opening 43 which communicates with the working channel ( 26 ) of the cannula 21 .
- a valve assembly 50 is illustrated within the valve housing 23 but could be disposed anywhere along the axis 27 .
- the valve assembly 50 includes a block 52 of gel material 54 .
- the block 50 forms a housing seal 55 with the vertical wall 34 to prevent the leak of insufflation gases between the gel material 54 and the housing 23 .
- the gel block 52 is further configured with a slit or opening 56 which in this embodiment extends along the axis 27 . This opening 56 is perhaps best illustrated in the cross sectional views of FIGS. 2A and 2B .
- valve assembly 50 is illustrated in the absence of the instrument 25 ( FIG. 1 ). Under these circumstances, the gel material 54 closes the opening 56 to form a zero seal 58 .
- the zero seal 58 in this embodiment is formed solely by the gel material 54 , generally along the axis 27 , and prevents the escape of insufflation gases through the gel block 52 in the absence of the instrument 25
- the gel block 52 is not merely a septum having only a thin dimension along the axis 27 . Rather, the block 52 is preferably formed so that the ratio of its thickness to its outermost dimension, such as its radius, is in a range between one and five. The thickness of the block 52 is preferably in a range between five and ten millimeters. In a preferred embodiment, the gel block 52 in the relaxed state shown in FIG. 2A , has a thickness of about seven millimeters and an outermost dimension, such as its radius about 21 millimeters. (In this case the ratio is about three).
- FIG. 3 Operation of the trocar 18 and associated valve assembly 50 is best illustrated in FIG. 3
- the instrument 25 is illustrated to be inserted off-axis through the opening 56 .
- the portions of the gel material 54 which define the opening 56 of the block 52 also form an instrument seal 61 with the instrument 25 .
- This instrument seal 61 prevents the escape of insufflation gases through the gel block 52 when the instrument 25 is present in the trocar 18 .
- FIG. 3 illustrates at least two aspects of the present invention, both of which relate to properties of the gel block 52 in the presence of the instrument 25 .
- the instrument seal ( 61 ) will move with the instrument 25 .
- the instrument 25 may be inserted along the axis 27 , it may also be inserted off-axis or moved off-axis, as illustrated in FIG. 3 , during the operation. Under these circumstances, it is important that the instrument seal 61 be maintained, or permitted to “float” with the off-axis movement of the instrument 25 .
- the instrument seal 61 is formed by both the instrument 25 and the valve assembly 50 ; however, since the instrument 25 will typically be rigid, it is up to the valve assembly 50 to accommodate this flotation.
- Another aspect of the invention associated with insertion of the instrument 25 relates to movement of the gel material 54 as the opening 56 is spread by the instrument 25 . As this opening 56 enlarges, the displaced gel material, which is generally non-compressible, will attempt to expand. In order to accommodate this expansion, it is desirable to provide air pockets or voids 65 into which the gel material 54 can move. These voids 65 are most prominently illustrated in FIG. 2A in the absence of the instrument 25
- FIG. 4 Another embodiment of the invention is illustrated in FIG. 4 .
- the cannula is designated with the reference numeral 21 a , the valve housing with the numeral 23 a , and the valve assembly with the number 50 a .
- the valve assembly 50 a includes a thin septum 70 with the opening 56 a disposed generally along the axis 27 a .
- the septum 70 will typically be formed of an elastomeric material and will be supported within the valve housing 23 a by the gel material 54 . In this case, the septum 70 is responsible for the zero seal 58 a as well as the instrument seal 61 a.
- the gel material 54 forms a seal with the septum 70 as well as the housing seal 55 a with the housing wall 34 a . It will be noted that in this embodiment, the gel material 54 provides floating support for the septum 27 . Any outward expansion required of the gel material can be accommodated by the voids 65 a between the gel material 54 and the horizontal walls 36 a and 38 a.
- FIG. 5 A further embodiment of the invention is illustrated in FIG. 5 , wherein elements of structure similar to those previously disclosed are designated with the same reference numeral followed by the lower case letter “b.”
- the embodiment of FIG. 5 differs from that of FIG. 4 primarily in the location of the gel block 52 b .
- the housing seal 55 b is formed around the axis 27 b between the gel block 52 and the horizontal walls 36 b and 38 b of the valve housing 23 b .
- the voids 65 b desired for expansion of the gel block 52 b can be located between the vertical wall 34 b and the gel block 52 b .
- This embodiment could include the elastomeric septum 70 b , or might comprise only the gel block 52 b as illustrated in the embodiment of FIG. 2A .
- FIG. 6 Another embodiment of the invention is illustrated in FIG. 6 , wherein elements of structure similar to those previously disclosed are designated with the same reference numeral followed by the lower case letter “c.”
- the block 52 c of gel material 54 c forms the housing seal 55 c around the axis 27 c with each of the housing walls 34 c , 36 c , and 38 c .
- the expansion voids 65 c can be formed as air pockets within the gel material 54 c of the block 52 c .
- the block 52 c is generally compressible, like a sponge, as the gel material 54 c can expand into the voids 56 c to reduce the volume of the block 52 c . With this compressibility, flotation of the valve assembly 50 c , can be greatly increased with respect to the axis 27 c.
- the voids 65 d are formed permanently within the walls of the housing 23 d .
- the voids 65 d can be formed in the horizontal wall 36 d to accommodate upward expansion of the gel block 52 d , as illustrated by an arrow 67 .
- the elastomeric septum 70 is insert molded with the gel block 52 d , and the housing seal 55 is formed between the gel block 52 d and the walls 34 d and 38 d.
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- Health & Medical Sciences (AREA)
- Surgery (AREA)
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- Medical Informatics (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Pathology (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
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Abstract
Description
Claims (17)
Priority Applications (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US11/753,752 US7651478B2 (en) | 2002-01-24 | 2007-05-25 | Surgical access device with floating gel seal |
US12/693,860 US7883493B2 (en) | 2002-01-24 | 2010-01-26 | Surgical access device with floating gel seal |
US13/007,210 US8500695B2 (en) | 2002-01-24 | 2011-01-14 | Surgical access device with floating gel seal |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US10/056,831 US7235062B2 (en) | 2002-01-24 | 2002-01-24 | Surgical access device with floating gel seal |
US11/753,752 US7651478B2 (en) | 2002-01-24 | 2007-05-25 | Surgical access device with floating gel seal |
Related Parent Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US10/056,831 Continuation US7235062B2 (en) | 2002-01-24 | 2002-01-24 | Surgical access device with floating gel seal |
Related Child Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US12/693,860 Continuation US7883493B2 (en) | 2002-01-24 | 2010-01-26 | Surgical access device with floating gel seal |
Publications (2)
Publication Number | Publication Date |
---|---|
US20070233006A1 US20070233006A1 (en) | 2007-10-04 |
US7651478B2 true US7651478B2 (en) | 2010-01-26 |
Family
ID=22006816
Family Applications (4)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US10/056,831 Expired - Lifetime US7235062B2 (en) | 2002-01-24 | 2002-01-24 | Surgical access device with floating gel seal |
US11/753,752 Expired - Fee Related US7651478B2 (en) | 2002-01-24 | 2007-05-25 | Surgical access device with floating gel seal |
US12/693,860 Expired - Fee Related US7883493B2 (en) | 2002-01-24 | 2010-01-26 | Surgical access device with floating gel seal |
US13/007,210 Expired - Fee Related US8500695B2 (en) | 2002-01-24 | 2011-01-14 | Surgical access device with floating gel seal |
Family Applications Before (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US10/056,831 Expired - Lifetime US7235062B2 (en) | 2002-01-24 | 2002-01-24 | Surgical access device with floating gel seal |
Family Applications After (2)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US12/693,860 Expired - Fee Related US7883493B2 (en) | 2002-01-24 | 2010-01-26 | Surgical access device with floating gel seal |
US13/007,210 Expired - Fee Related US8500695B2 (en) | 2002-01-24 | 2011-01-14 | Surgical access device with floating gel seal |
Country Status (5)
Country | Link |
---|---|
US (4) | US7235062B2 (en) |
EP (1) | EP1467784B1 (en) |
JP (1) | JP4263616B2 (en) |
CA (1) | CA2472362C (en) |
WO (1) | WO2003061738A1 (en) |
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US20110208007A1 (en) * | 2010-01-20 | 2011-08-25 | EON Surgical Ltd. | Rapid Laparoscopy Exchange System And Method Of Use Thereof |
US9078697B2 (en) * | 2009-03-18 | 2015-07-14 | Covidien Lp | Surgical portal apparatus including movable housing |
US9138207B2 (en) | 2009-05-19 | 2015-09-22 | Teleflex Medical Incorporated | Methods and devices for laparoscopic surgery |
US10028731B2 (en) | 2013-11-12 | 2018-07-24 | Genzyme Corporation | Barrier application device |
US10052088B2 (en) | 2010-01-20 | 2018-08-21 | EON Surgical Ltd. | System and method of deploying an elongate unit in a body cavity |
US10390694B2 (en) | 2010-09-19 | 2019-08-27 | Eon Surgical, Ltd. | Micro laparoscopy devices and deployments thereof |
KR20190131680A (en) * | 2018-05-17 | 2019-11-27 | 인제대학교 산학협력단 | Laparoscopioc trocar |
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Also Published As
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US7235062B2 (en) | 2007-06-26 |
CA2472362A1 (en) | 2003-07-31 |
EP1467784A4 (en) | 2008-06-18 |
US20070233006A1 (en) | 2007-10-04 |
JP2005515036A (en) | 2005-05-26 |
US8500695B2 (en) | 2013-08-06 |
CA2472362C (en) | 2010-01-12 |
US20030139756A1 (en) | 2003-07-24 |
US20100125248A1 (en) | 2010-05-20 |
JP4263616B2 (en) | 2009-05-13 |
US20110112480A1 (en) | 2011-05-12 |
US7883493B2 (en) | 2011-02-08 |
WO2003061738A1 (en) | 2003-07-31 |
EP1467784B1 (en) | 2013-05-15 |
EP1467784A1 (en) | 2004-10-20 |
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